When the fertilized egg attaches itself in a place other than inside the uterus, it is called an ectopic pregnancy. Almost all ectopic pregnancies occur in the fallopian tubes, and they are called tubal pregnancies. The fallopian tubes are not physiologically designed to hold a growing embryo and therefore the fertilized egg in a tubal pregnancy cannot grow and develop properly and must be treated accordingly. The major health risk of ectopic pregnancy is rupture leading to internal bleeding.
There are various factors that increase the likelihood of a woman having a tubal pregnancy, but it is important to note that such a pregnancy may occur even without any of the risk factors.
Some of the factors that may increase the likelihood of a tubal pregnancy are:
- Most likely to occur in women between thirty-five to forty-four years of age.
- Prior history of a tubal or ectopic pregnancy.
- Surgery on the fallopian tubes such as tubal sterilization etc. can lead to scarring. Disruption of the normal anatomy of the tubes increases the risk of a tubal pregnancy. Similarly, infection, congenital abnormalities, or tumours of the fallopian tubes can increase a woman’s risk of having a tubal pregnancy.
- Infection of the pelvis (pelvic inflammatory disease) is another risk factor.
- Conditions such as endometriosis, fibroid tumours, or pelvic scar tissue (pelvic adhesions), can narrow the fallopian tubes and hinder the movement of the eggs thereby increasing the chances of a tubal pregnancy.
- Cigarette smoking has been associated with an increased risk of tubal pregnancies.
Symptoms of a tubal pregnancy are weakness or dizziness caused by serious internal bleeding and low blood pressure. Severe bleeding may also cause a shoulder ache. Heavy bleeding, with a weak and rapid pulse during pregnancy are all signs of a tubal pregnancy.
Diagnosis of a tubal pregnancy is first done by the doctor who during a pelvic examination may find a tender mass. If a tubal pregnancy is suspected, then a blood hormone test and a pelvic ultrasound can confirm the diagnosis.
Treatments for tubal pregnancy include observation, laparoscopy, laparotomy, and medication. Some tubal pregnancies resolve on their own while others need urgent surgery due to life-threatening bleeding. However, because of the risk of rupture and potential consequences, most women with a diagnosed ectopic pregnancy are treated with medications or surgery.